íl^ffl W o r l d Health Organization
^^^^ Organisation mondiale de la Santé
FORTY-NINTH WORLD HEALTH ASSEMBLY
Provisional agenda item 30.1 A49/31 16 May 1996
Collaboration within the United Nations system and with other intergovernmental organizations
International Programme to mitigate the Health Effects of the Chernobyl Accident (IPHECA)
Report by the Director-General
In view of the importance of the results and conclusions of recent conferences (Geneva, November 1995; Minsk, March 1996; Vienna, April 1996) summarizing the health effects 10 years after the Chernobyl accident, the Director General submits this report on IPHECA to the Health Assembly. It contains a summary of the health effects, particularly the massive increase in childhood thyroid cancer and the possibility of increases in other radiation- and non-radiation-related effects of the Chernobyl accident. Future activities of IPHECA are included, such as the monitoring and evaluation of the long-term consequences of the accident, that need special attention, if valuable information is not to be lost that might serve in the organization of medical care and the handling of any future accident. The Health Assembly may wish to consider the draft resolution contained in the report.
I. INTRODUCTION
1. IPHECA was initiated in mid-1991 following its endorsement by the Forty-fourth World Health Assembly in May 1991. Since then its activities have involved the development and implementation of five pilot projects: on haematology, thyroid conditions, brain damage in utero, epidemiological registry, and oral health in Belarus. These pilot projects were essentially completed by the end of 1994 and a summary report was published in 1995.'
2. The International Programme was envisaged as a flexible long-term effort whose duration would depend on the needs, and on the availability of resources. Its main objective is to contribute to the efforts to alleviate the health consequences of the accident by assisting the health authorities in Belarus, the Russian Federation and Ukraine.
Health consequences of the Chernobyl accident: summary report. Geneva, World Health Organization, 1995.
A49/1881
3. The health consequences of the Chernobyl accident have been discussed at three international conferences associated with the tenth anniversary of the catastrophe. The first was organized by W H O together with the Republic and Canton of Geneva and the ministries of health of Belarus, the Russian Federation and Ukraine, in Geneva, in November 1995. The second, organized by the European Commission (EC) jointly with the ministries for Chernobyl affairs, emergency situations and health in Belarus, the Russian Federation and Ukraine, was held in Minsk, Belarus, in March 1996. The third, an EC/IAEA/WHO conference, was held in Vienna, Austria, in April 1996.
4. This document summarizes the scientific information obtained so far on the health effects. It also provides information on future activities recommended by IPHECA's Management Committee.
II. SUMMARY OF HEALTH CONSEQUENCES Acute radiation effects
5. The diagnosis of acute radiation sickness was confirmed in 134 cases of the 237 people hospitalized.
O f these, 28 died in the first three months. Three more died due to non-radiation causes at the accident site, bringing the total to 31 deaths. After the acute phase, 14 more people have died over the last 10 years.
Thyroid cancer
6. A very significant increase in childhood thyroid cancer has been observed in Belarus, the Russian Federation and Ukraine following the Chernobyl accident. The number of reported cases up to the end of 1995 is about 800 in children up to 14 years of age at the time of exposure. More than 400 of these cases have been observed in Belarus. Thyroid cancer rates in contaminated territories of the three affected countries increased 20-40 times compared to the pre-accident period. In the most contaminated, Gomel oblast (Belarus), a 100-fold increase has been observed.
Incidence of leukaemia，and other longer-term effects on health
7. To date no consistent attributable increase has been detected in the rate of leukaemia, one of the major causes of concern after radiation exposure. Cases may be expected, given the short period covered by this study. However, since the peak in the incidence of blood disorders may occur more than 10 years after the accident, long-term studies of these diseases are needed.
8. Apart from thyroid cancer in young people, there have been reports of increases in the incidence of specific malignancies and a possible acceleration in the occurrence of cancer (including leukaemia and thyroid cancer) among adult participants in the clean-up operations at Chernobyl and some people living in contaminated territories.
9. Increases in the frequency of a number of non-specific effects, other than cases of cancer, have also been reported. They include cardiovascular, endocrinological, haematological, gastrointestinal, neurological and psychiatric disorders and diseases. However, further follow-up of the affected population is needed to determine the causes of such increases.
10. There are significant non-radiation-related health disorders and symptoms such as anxiety, depression and various psychosomatic disorders attributable to mental stress among the population in the region.
11. Some preliminary evidence was found to suggest retarded mental development and deviations in behavioural and emotional reactions in children exposed to radiation in utero.
